Module 1

Roger Gould's Developement themes

1. In their 20s with "I have to get away from my parents." 2. Occurs during the early 30s and asks, "Is what I am the only way for me to be?" Occurs when young adults experience the consequences of the decisions of their independence. 3. Occurs in the mid to late 30s and asks, "Have I done the right thing? Is there time to change?" 4. Identified in the 40s, "The die is cast" indicates resignation and the belief that possibilities are limited. 5. During the 50s a decrease in negativism occurs. Finds a realization of mortality with a concern for one's state of health. There is less responsibility for the welfare of the children and more attachment to the spouse.

Four broad aims of nursing practice can be identified in the definitions of nursing:

1. To promote health 2. To prevent illness 3. To restore health 4. To facilitate coping with disability or death

conceptual framework or model

A group of concepts that follows an understandable pattern

Isabel Hampton Robb

A leader in nursing and nursing education; organized the nursing school at Johns Hopkins Hospital; initiated policies that included limiting the number of hours in a day's work and wrote a textbook to help student learning; the first president of the Nurses Associated Alumnae of the United States and Canada (which later became the American Nurses Association)

Elizabeth Smellie

A member of the original Victorian Order of Nurses for Canada (a group that provided public health nursing); organized the Canadian Women's Army Corps during World War II

Harriet Tubman

A nurse and an abolitionist; active in the underground railroad movement before joining the Union Army during the Civil War

Louise Schuyler

A nurse during the Civil War; returned to New York and organized the New York Charities Aid Association to improve care of the sick in Bellevue Hospital; recommended standards for nursing education

Lavinia Dock

A nursing leader and women's rights activist; instrumental in the Constitutional amendment giving women the right to vote

Nursing theory

is developed to describe nursing. Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices.

Science

is observing, identifying, describing, investigating, and explaining events and occurrences that are perceived in the world. It implies a body of knowledge. The science of nursing is the knowledge in and of nursing.

Philosophy

is the study of wisdom, fundamental knowledge, and the processes used to develop and construct one's perceptions of life. Philosophy provides a viewpoint and implies a system of values and beliefs.

theory

is composed of a group of concepts that describe a pattern of reality.

Erik Erikson's stages of psychosocial development

(1) Trust vs. Mistrust; (2) Autonomy vs. Shame; (3) Initiative vs. Guilt; (4) Industry vs. Inferiority; (5) Identity vs. Confusion; (6) Intimacy vs. Isolation; (7) Generativity vs. Self-absorption; (8) Integrity vs. Despair.

Four concepts common in nursing theory that influence and determine nursing practice are

(1) the person (patient), (2) the environment, (3) health, and (4) nursing.

informed consent

, the patient's right to consent knowledge- ably to participate in a study without coercion (knowing that this consent may be withdrawn at any time) or to refuse to participate without jeopardizing the care that he or she will receive, the right to confidentiality, and the right to be protected from harm.

A patient is having dyspnea. What would the nurse do first? a. Remove pillows from under the head b. Elevate the head of the bed c. Elevate the foot of the bed d. Take the blood pressure

b. Elevating the head of the bed allows the abdominal organs to descend, giving the diaphragm greater room for expansion and facilitating lung expansion.

Lawrence Kohlberg

Famous for his theory of moral development in children; made use of moral dilemmas in assessment

Genital Stage (Ages 12 to 20 Years)

At this stage, sexual interest can be expressed in overt sexual relationships. Sexual pressures and conflicts typically cause turmoil as the adolescent makes adjustments in relationships.

Mary Adelaide Nutting

Became the first professor of nursing in the world as a faculty member of Teachers' College, Columbia University; with Lavinia Dock, published the four-volume History of Nursing

Florence Nightingale

Defined nursing as both an art and a science, differentiated nursing from medicine, created free- standing nursing education; published books about nursing and health care; is regarded as the founder of modern nursing

Mary Agnes Snively

Director of the nursing school at Toronto General Hospital and one of the founders of the Canadian Nurses Association

Concrete Operational Stage (Ages 7 to 11 Years)

During this stage, children learn by manipulating concrete or tangible objects and can classify articles according to two or more characteristics. Logical thinking is developing, with an understanding of reversibility, relations between numbers, and loss of egocentricity, in addition to the ability to incorporate another's perspective. Children become increasingly aware of external events and realize that their feelings and thoughts are unique and may not be the same as those of other children their age. They have the ability to focus on multiple parts of a problem at the same time.

Lillian Wald

Established a neighborhood nursing service for the sick poor of the Lower East Side in New York City; the founder of public health nursing

Nora Gertrude Livingston

Established a training program for nurses at the Montreal General Hospital (the first 3-year program in North America)

Mary Breckenridge

Established the Frontier Nursing Service and one of the first midwifery schools in the United States

Margaret Sanger

Founder of Planned Parenthood

Mary Elizabeth Mahoney

Graduated from the New England Hospital for Women and Children in 1879 as America's first African American nurse

Linda Richards

Graduated in 1873 from the New England Hospital for Women and Children in Boston, Massachusetts, as the first trained nurse in the United States; became the night superintendent of Bellevue Hospital in 1874 and began the practice of keeping records and writing orders

Robert J. Havighurst

Identified specific developmental tasks (6 stages) that he believed Children must master if they are to develop normally. Also believed in "teachable moments"

COMMON CAUSES Of DISEASES

Inherited genetic defects • Developmental defects resulting from exposure to such factors as virus or chemicals during pregnancy • Biologic agents or toxins • Physical agents such as temperature, chemicals, and radiation • Generalized tissue responses to injury or irritation • Physiologic and emotional reactions to stress • Excessive or insufficient production of body secretions (hormones, enzymes, and so forth)

Nursing

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.

Mary Ann Bickerdyke

Organized diet kitchens, laundries, and an ambulance service, and supervised nursing staff during the Civil War

Nurse practice acts are laws established in each state in the United States to regulate the practice of nursing.

Protect the public by defining the legal scope of nursing practice, excluding untrained or unlicensed people from practicing nursing. • Create a state board of nursing or regulatory body having the authority to make and enforce rules and regulations concerning the nursing profession. • Define important terms and activities in nursing, including legal requirements and titles for RNs and LPNs

Sojourner Truth

Provided nursing care to soldiers during the Civil War and worked for the women's movement

Jane Addams

Provided social services within a neighborhood setting; a leader for women's rights; recipient of the 1931 Nobel Peace prize

What is the leading cause of cognitive impairment in old age? a. Stroke b. Malnutrition c. Alzheimer disease d. Loss of cardiac reserve

c. Alzheimer disease is the most common degenerative neurologic illness and the most common cause of cognitive impairment. It is irreversible, progressing from deficits in memory and thinking skills to an inability to perform even the simplest of tasks.

Dorothea Dix

Served as superintendent of the Female Nurses of the Army during the Civil War; was given the authority and the responsibility for recruiting and equipping a corps of army nurses; was a pioneering crusader for the reform of the treatment of the mentally ill

Phallic Stage (Ages 3 to 7 Years)

The child has increased interest in gender differences and his or her own gender. The child experiences conflict and resolution of that conflict with the parent of the same sex (named the Oedipus complex in boys and the Electra complex in girls, based on feelings of intimate sexual possessiveness for the opposite-sex parent). Curiosity about the genitals and masturbation increase during this stage.

Nursing is recognized increasingly as a profession

Well-defined body of specific and unique knowledge • Strong service orientation • Recognized authority by a professional group • Code of ethics • Professional organization that sets standards • Ongoing research • Autonomy and self-regulation

Daniel Levinson and Associates

The theory centered on the belief that the pattern of life at any point in time is formed by the interaction of three components: the self (values, motives), the social and cultural aspects of one's life (family, career, religion, ethnic background), and the particular set of roles in which one participates (husband, father, friend, student). When anything changes in one component, the whole life structure must then reorganize.

Preoperational Stage (Ages 2 to 7 Years)

This stage is characterized by the beginning use of symbols, through increased language skills and pictures, to represent the preschooler's world. This stage is divided into two parts: the preconceptual stage (ages 2-4 years) and the intuitive stage (ages 4-7 years). Play activities during this time help the child to understand life events and relationships.

Formal Operational Stage (Age 11 Years or Older)

This stage is characterized by the use of abstract thinking and deductive reasoning. General concepts are related to specific situations and alternatives are considered. The world is evaluated by testing beliefs in an attempt to establish values and meaning in life.

Sensorimotor Stage (Birth to 24 Months)

This stage is marked by progression through a series of developmental tasks, for example: • 0to1month—Demonstrates basic reflexes, such as sucking • 1 to 4 months—Discovers enjoyment of random behaviors (such as smiling or sucking thumb) and repeats them • 4 to 8 months—Relates own behavior to a change in environment, such as shaking a rattle to hear the sound or manipulating a spoon to eat • 8 to 12 months—Coordinates more than one thought pat- tern at a time to reach a goal, such as repeatedly throwing an object on the floor; only objects in sight are considered permanent • 12 to 18 months—Recognizes the permanence of objects, even if out of sight; can understand simple commands • 18 to 24 months—Begins to develop reasoning and can anticipate events

Latency Stage (Ages 7 to 12 Years)

This stage marks the transition to the genital stage during adolescence. Increasing sex-role identification with the par- ent of the same sex prepares the child for adult roles and relationships.

Clara Barton

Volunteered to care for wounds and feed Union soldiers during the Civil War; served as the supervisor of nurses for the Army of the James, organizing hospitals and nurses; established the Red Cross in the United States in 1882

One of the four broad aims of nursing practice is to restore health. Which examples of nursing interventions reflect this goal? Select all that apply. a. A nurse counsels adolescents in a drug rehabilitation program. b. A nurse performs range-of-motion exercises for a patient on bedrest. c. A nurse shows a diabetic patient how to inject insulin. d. A nurse recommends a yoga class for a busy executive. e. A nurse provides hospice care for a patient with end-stage cancer. f. A nurse teaches a nutrition class at a local high school.

a, b, c. Activities to restore health focus on the individual with an illness and range from early detection of a disease to rehabilitation and teaching during recovery. These activities include drug counseling, teaching patients how to administer their medications, and performing range-of-motion exercises for bedridden patients. Recommending a yoga class for stress reduction is a goal of preventing illness, and teaching a nutrition class is a goal of promoting health. A hospice care nurse helps to facilitate coping with disability and death.

A high school nurse is counseling parents of teenagers who are beginning high school. Which issues would be priority topics of discussion for this age group? Select all that apply. a. The influence of peer groups b. Bullying c. Water safety d. Eating disorders e. Risk taking behavior f. Immunizations

a, b, d, e. Appropriate topics of discussion for parents of adolescents include peer groups, bullying, eating disorders, and risk-taking behaviors. Immunizations would be appropriate for parents of children from infants to school-age, and water safety should be taught in the preschool years.

A nurse researcher studies the effects of genomics on current nursing practice. Which statements identify genetic principles that will challenge nurses to integrate genomics in their research, education, and practice? Select all that apply. a. Genetic tests plus family history tools have the potential to identify people at risk for diseases. b. Pharmacogenetic tests can determine if a patient is likely to have a strong therapeutic response to a drug or suffer adverse reactions from the medication. c. Evidence-based review panels are in place to evaluate the possible risks and benefits related to genetic testing. d. Valid and reliable national data are available to establish baseline measures and track progress toward targets. e. Genetic variation can either accelerate or slow the metabolism of many drugs. f. It is beyond the role of the nurse to answer questions and discuss the impact of genetic findings on health and illness.

a, b, e. In the very near future, all health care providers will be challenged to integrate genomics into their research, education, and practice (Healthy People 2020, 2012). Genetic tests plus family history tools have the potential to identify people at risk for diseases. Pharmacogenetics is the study of how genetic variation affects an individual's response to drugs. Pharmacogenetic tests can determine if a patient is likely to have a strong therapeutic response to a drug or suf- fer adverse reactions from the medication. Genetic variation can either accelerate or slow the metabolism of many drugs (Lehne, 2013; Human Genome Project, 2011). Two emerging challenges related to genomic discoveries are (1) the need for evidence-based review panels to thoroughly evaluate the possible benefits and harms related to the expanding number of genetic tests and family health history tools, and (2) valid and reliable national data are needed to establish baseline measures and track progress toward targets (Healthy People 2020, 2012). Nurses must be prepared to answer questions and discuss the impact of genetic findings on health and illness.

A nurse caring for older adults in a long-term care facility knows that several physical changes occur in the aging adult. Which characteristics best describe these changes? Select all that apply. a. Fatty tissue is redistributed. b. The skin is drier and wrinkles appear. c. Cardiac output increases. d. Muscle mass increases. e. Hormone production increases. f. Visual and hearing acuity diminishes.

a, b, f. Physical changes occurring with aging include these: fatty tissue is redistributed, the skin is drier and wrinkles appear, and visual and hearing acuity diminishes. Cardiac output decreases, muscle mass decreases, and hormone production decreases, causing menopause or andropause.

A nurse is practicing community-based nursing in a mobile health clinic. What would be the central focus of this nurse's care? a. Individual and family health care needs b. Populations within the community c. Local health care facilities d. Families in crisis

a. In contrast to community health nursing, which focuses on populations within a community, community-based nurs- ing is centered on individual and family health care needs. Community-based nurses may help families in crisis and work in health care facilities, but these are not the focus of community-based nursing

In addition to standard precautions, the nurse would initiate droplet precautions for which patients? Select all that apply. a. A patient diagnosed with rubella b. A patient diagnosed with diptheria c. A patient diagnosed with varicella d. A patient diagnosed with tuberculosis e. A patient diagnosed with MRSA f. An infant diagnosed with adenovirus infection

a, b, f. Rubella, diphtheria, and adenovirus infection are illnesses transmitted by large-particle droplets and require droplet precautions in addition to standard precautions. Air- borne precautions are used for patients who have infections spread through the air with small particles, for example, tuberculosis, varicella, and rubeola. Contact precautions are used for patients who are infected or colonized by a multidrug-resistant organism (MDRO), such as MRSA.

The rectal temperature, a core temperature, is considered to be one of the most accurate routes. In which cases would taking a rectal temperature be contraindicated? Select all that apply. a. A newborn who has hypothermia b. A child who has pneumonia c. An older patient who is post myocardial infarction (heart attack) d. A teenager who has leukemia e. A patient receiving erythropoietin to replace red blood cells f. An adult patient who is newly diagnosed with pancreatitis

a, c, d, e. The rectal site should not be used in newborns, children with diarrhea, and in patients who have undergone rectal surgery. The insertion of the thermometer can slow the heart rate by stimulating the vagus nerve, thus patients post-MI should not have a rectal temperature taken. Assessing a rectal temperature is also contraindicated in patients who are neutropenic (have low white blood cell counts, such as in leukemia), in patients who have certain neurologic disorders, and in patients with low platelet counts.

A nurse is caring for patients in an isolation ward. In which situations would the nurse appropriately use an alcohol- based handrub to decontaminate the hands? Select all that apply. a. The nurse is providing a bed bath for a patient. b. The nurse has visibly soiled hands after changing the bed- ding of a patient. c. The nurse removes gloves when patient care is completed. d. The nurse is inserting a urinary catheter for a female patient. e. The nurse is assisting with a surgical placement of a cardiac stent. f. The nurse removes old magazines from a patient's table.

a, c, d, f. It is recommended to use an alcohol-based handrub in the following situations: before direct contact with patients; after direct contact with patient skin; after contact with body fluids if hands are not visibly soiled; after removing gloves; before inserting urinary catheters, peripheral vascular catheters, or invasive devices that do not require surgical placement; before donning sterile gloves prior to an invasive procedure; if moving from a contaminated body site to a clean body site; and after contact with objects contaminated by the patient.

The student nurse learns that illnesses are classified as either acute or chronic. Which are examples of chronic illnesses? Select all that apply. a. Diabetes mellitus b. Bronchial pneumonia c. Rheumatoid arthritis d. Cystic fibrosis e. Fractured hip f. Otitis media

a, c, d. Diabetes, arthritis, and cystic fibrosis are chronic diseases because they are permanent changes caused by irreversible alterations in normal anatomy and physiology, and they require patient education along with a long period of care or support. Pneumonia, fractures, and otitis media are acute illnesses because they have a rapid onset of symptoms that last a relatively short time.

The nurse caring for infants in a hospital nursery knows that newborns continue to grow and develop according to individual growth patterns and developmental levels. Which terms describe these patterns? Select all that apply. a. Orderly b. Simple c. Sequential d. Unpredictable e. Differentiated f. Integrated

a, c, e, f. Growth and development are orderly and sequential, as well as continuous and complex. Growth and development follow regular and predictable trends, and are both differenti- ated and integrated.

A nurse is assessing the vital signs of patients who presented at the emergency department. Based on the knowledge of age-related variations in normal vital signs, which patients would the nurse document as having a normal vital sign? Select all that apply. a. A 4-month old infant whose temperature is 38.1°C (100.5°F) b. A 3-year old whose blood pressure is 118/80 c. A 9-year old whose temperature is 39°C (102.2°F) d. An adolescent whose pulse rate is 70 bpm e. An adult whose respiratory rate is 20 bpm f. A 72-year old whose pulse rate is 42 bpm

a, d, e, f. The normal temperature range for infants is 37.1°C to 38.1°C (98.7°F-100.5°F). The normal pulse rate for an adolescent is 55 to 105. The normal respiratory rate for an adult is 12 to 20 bpm and the normal pulse for an older adult is 40 to 100 bpm. The normal blood pressure for a toddler is 89/46 and the normal temperature for a child is 36.8°C to 37.8°C (98.2°F-100°F; refer to Table 24-1, Age-Related Variations in Normal Vital Signs).

A nurse is teaching parents of preschoolers what type of behavior to expect from their children based on developmental theories. Which statements describe this stage of development? Select all that apply. a. According to Freud, the child is in the phallic stage. b. According to Erikson, the child is in the trust versus mistrust stage. c. According to Havighurst, the child is learning to get along with others. d. According to Fowler, the child imitates religious behavior of others. e. According to Kohlberg, the child defines satisfying acts as right. f. According to Havighurst, the child is achieving gender-specific roles.

a, d, e. According to Freud, the child is in the phallic stage. According to Fowler, the child imitates religious behavior of others. According to Kohlberg, the child defines satisfying acts as right. According to Erikson, the child is in the initiative versus guilt stage. According to Havighurst, the child is learning sex differences, forming concepts, and getting ready to read. According to Havighurst, the adolescent, not the preschooler, is achieving gender-specific social roles.

A patient complains of severe abdominal pain. When assess- ing the vital signs, the nurse would not be surprised to find what assessments? Select all that apply. a. An increase in the pulse rate b. A decrease in body temperature c. A decrease in blood pressure d. An increase in respiratory depth e. An increase in respiratory rate f. An increase in body temperature

a, e. The pulse often increases when a person is experiencing pain. Pain does not affect body temperature and may increase (not decrease) blood pressure. Acute pain may increase respiratory rate but decrease respiratory depth.

When providing health promotion classes, a nurse uses con- cepts from models of health. What do both the health-illness continuum and the high-level wellness models demonstrate? a. Illness as a fixed point in time b. The importance of family c. Wellness as a passive state d. Health as a constantly changing state

d. Both these models view health as a dynamic (constantly changing state).

A nurse performs an assessment of a family consisting of a single mother, a grandmother, and two children. Which inter- view questions directed to the single mother could the nurse use to assess the affective and coping family function? Select all that apply. a. Who is the person you depend on for emotional support? b. Who is the breadwinner in your family? c. Do you plan on having any more children? d. Who keeps your family together in times of stress? e. What family traditions do you pass on to your children? f. Do you live in an environment that you consider safe?

a,d.The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. Asking who provides emotional support in times of stress assesses the affective and coping function. Assessing the breadwinner focuses on the economic function. Inquiring about having more children assesses the reproductive function, asking about family traditions assesses the socialization function, and checking the environment assesses the physical function.

It is important to have the appropriate cuff size when taking the blood pressure. What error may result from a cuff that is too large or too small? a. An incorrect reading b. Injury to the patient c. Prolonged pressure on the arm d. Loss of Korotkoff sounds

a. A blood pressure cuff that is not the right size may cause an incorrect reading.

A nurse performing an assessment of a newborn in the neonatal unit records these findings: heart rate 85 bpm, irregular respiratory rate, normal muscle tone, weak crying, and bluish tint to skin. Using the APGAR scoring chart (see Table 18-1, p. 389) what would be the score for this newborn? a.5 b.7 c.8 d. 10

a. A newborn with a heart rate less than 100 bpm, irregular respiratory effort, normal muscle tone, weak cry, and bluish tint to the skin scores a 5 on the APGAR chart.

A registered nurse assumes the role of nurse coach to provide teaching to patients who are recovering from strokes. One example of an intervention the nurse may provide related to this role is: a. The nurse uses discovery to identify the patients' personal goals and create an agenda that will result in change. b. The nurse is the expert in providing teaching and education strategies to provide dietary and activity modifications. c. The nurse becomes a mentor to the patients and encourages them to create their own fitness programs. d. The nurse assumes an authoritative role to design the structure of the coaching session and support the achievement of patient goals.

a. A nurse coach establishes a partnership with a patient and, using discovery, facilitates the identification of the patient's personal goals and agenda to lead to change rather than using teaching and education strategies with the nurse as the expert. A nurse coach explores the patient's readiness for coaching, designs the structure of a coaching session, supports the achievement of the patient's desired goals, and with the patient determines how to evaluate the attainment of patient goals.

A patient has a blood pressure reading of 130/90 mm Hg when visiting a clinic. What would the nurse recommend to the patient? a. Follow-up measurements of blood pressure b. Immediate treatment by a physician c. No action, because the nurse considers this reading is due to anxiety d. A change in dietary intake

a. A single blood pressure reading that is mildly elevated is not significant, but the measurement should be taken again over time to determine if hypertension is a problem. The nurse would recommend a return visit to the clinic for a recheck.

A nurse is caring for an 80-year-old female patient who is living in a long-term care facility. To help this patient adapt to her present circumstances, the nurse is using reminiscence as therapy. Which question would encourage reminiscence? a. "Tell me about how you celebrated Christmas when you were young." b. "Tell me how you plan to spend your time this weekend." c. "Did you enjoy the choral group that performed here yesterday? d. "Why don't you want to talk about your feelings?"

a. Asking questions about events in the past can encourage the older adult to relive and restructure life experiences.

A nurse is preparing to teach a 45-year-old male patient with asthma how to use his inhaler. Which teaching tool is one of the best methods to teach the patient this skill? a. Demonstration b. Lecture c. Discovery d. Panel session

a. Demonstration of techniques, procedures, exercises, and the use of special equipment is an effective patient teaching strategy for a skill. Lecture can be used to deliver information to a large group of patients but is more effective when the session is interactive; it is rarely used for individual instruction, except in combination with other strategies. Discovery is a good method for teaching problem-solving techniques and independent thinking. Panel discussions can be used to impart factual material but are also effective for sharing experiences and emotions.

World War II had a tremendous effect on the nursing profession. Which development occurred during this period? a. The role of the nurse was broadened. b. There was a decreased emphasis on education. c. Nursing was practiced mainly in hospital settings. d. There was an overabundance of nurses.

a. During World War II, large numbers of women worked outside the home. They became more independent and assertive, which led to an increased emphasis on education. The war itself created a need for more nurses and resulted in a knowledge explosion in medicine and technology. This trend broadened the role of nurses to include practicing in a wide variety of health care settings.

A patient who is febrile may lose body heat through perspira- tion. The nurse recognizes that this is an example of what mechanism of heat loss? a. Evaporation b. Convection c. Radiation d. Conduction

a. Evaporation is the conversion of a liquid to a vapor as occurs when body fluid in the form of perspiration is vaporized from the skin. With convection, the heat is disseminated by motion between areas of unequal density, for example, the action of a fan blowing cool air over the body. An example of radiation (diffusion of heat by electromagnetic waves) is the body giving off heat from uncovered areas. In conduction, the heat is transferred to another object during direct contact, for example, body heat melting an ice pack.

A 2-year-old grabs a handful of cake from the table and stuffs it in his mouth. According to Freud, what part of the mind is the child satisfying? a. Id b. Superego c. Ego d. Unconscious mind

a. Freud defined the id as the part of the mind concerned with self-gratification by the easiest and quickest available means.

A nurse follows accepted guidelines for a healthy lifestyle. How can this promote health in others? a. By being a role model for healthy behaviors b. By not requiring sick days from work c. By never exposing others to any type of illness d. By spending less money on food

a. Good personal health enables the nurse to serve as a role model for patients and families.

A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice? a. Madeline Leininger b. Jean Watson c. Dorothy E. Johnson d. Betty Newman

a. Madeline Leininger's theory provides the foundations of transcultural nursing care by making caring the central theme of nursing. Jean Watson stated that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. The central theme of Dorothy E. Johnson's theory is that problems arise due to disturbances in the system or subsystem or functioning below optimal level. Betty Newman proposed that humans are in constant relationship with stressors in the environment and the major concern for nursing is keeping the patient system stable through accurate assessment of these stressors.

Which factor initially influences moral development as described in Kohlberg's theory? a. Parent-child communications b. Societal rules and regulations c. Social and religious rules d. One's beliefs and values

a. Moral development in the young child results from communications as the child tries to please his or her parents.

Nurse practice acts are established in each state of the United States to regulate nursing practice. What is a common element of every state practice act? a. Defining the legal scope of nursing practice b. Providing continuing education programs c. Determining the content covered in the NCLEX examination d. Creating institutional policies for health care practices

a. Nurse practice acts are established in each state to regulate the practice of nursing by defining the legal scope of nursing practice, creating a state board of nursing to make and enforce rules and regulations, define important terms and activities in nursing, and establish criteria for the education and licensure of nurses. The acts do not determine the content covered on the NCLEX, but they do have the legal authority to allow graduates of approved schools of nursing to take the licensing examination. The acts also may determine educational requirements for licensure, but do not provide the education. Institutional policies are created by the institutions themselves.

A nurse is teaching new mothers about infant care and safety. What would the nurse accurately include as a teaching point? a. Keep infants younger than 6 months out of direct sunlight. b. Use honey instead of sugar in homemade baby food. c. Place the baby on his or her stomach for sleeping. d. Keep crib rails down at all times.

a. Nurses should teach parents to keep infants younger than 6 months out of direct sunlight and cover them with protective clothing and hats. The nurse should also teach parents not to add honey or sugar to homemade baby food, to place the baby on the back for sleeping to prevent SIDS, and to keep the crib rails up at all times.

A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important? a. Person b. Environment c. Health d. Nursing

a. Of the four concepts, the most important is the person. The focus of nursing, regardless of definition or theory, is the person.

A mother tells the nurse that she is worried about her 4-year- old daughter because she is "overly attached to her father and won't listen to anything I tell her to do." What would be the nurse's best response to this parental concern? a. Tell the mother that this is normal behavior for a preschooler. b. Tell the mother that she and her family should see a counselor. c. Tell the mother that she should try to spend more time with her daughter. d. Tell the mother that her child should be tested for autism.

a. Preschoolers, according to Freud, are in the phallic stage, with the biologic focus primarily genital. The child has a sexual desire for the opposite-sex parent, but as means of defense strongly identifies with the same-sex parent. This is normal behavior for a preschooler, and the family does not need counseling or autism testing. Spending more time with the child is always a good idea, but is not the solution to this concern.

A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be performed more efficiently and effectively. What is the term for this type of theory affecting change in clinical nursing practice? a. Prescriptive theory b. Descriptive theory c. Developmental theory d. General systems theory

a. Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice. Descriptive theories describe a phenomenon, an event, a situation, or a relationship. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. General systems theory describes how to break whole things into parts and then to learn how the parts work together in "systems."

A nurse caring for elderly patients in a long-term care facility encourages an older adult to reminisce about her past life events. This life review, according to Erikson, is demonstrating what developmental stage of the later adult years? a. Ego integrity b. Generativity c. Intimacy d. Initiative

a. Reminiscence during the older years of one's life provides a sense of fulfillment and purpose (ego integrity). Generativity is a developmental stage of the middle adult years. Intimacy is a developmental task of the adolescent to adult years, and initiative is a task of the preschooler to early school-age years.

Two nurses are taking an apical-radial pulse and note a difference in pulse rate of 8 beats per minute. The nurse would document this difference as which of the following? a. Pulse deficit b. Pulse amplitude c. Ventricular rhythm d. Heart arrhythmia

a. The difference between the apical and radial pulse rate is called the pulse deficit.

The agent-host-environment model of health and illness is based on what concept? a. Risk factors b. Demographic variables c. Behaviors to promote health d. Stages of illness

a. The interaction of the agent, host, and environment creates risk factors that increase the probability of disease.

Standards

allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where health care is provided.

reciprocity

allows a nurse to apply for and be endorsed as a registered nurse by another state.

Applied research

also called practical research, is designed to directly influence or improve clinical practice.

A school nurse is performing an assessment of a student who states: "I'm too tired to keep my head up in class." The student has a low-grade fever. The nurse would interpret these findings as indicating which stage of infection? a. Incubation period b. Prodromal stage c. Full stage of illness d. Convalescent period

b. During the prodromal stage, the person has vague signs and symptoms, such as fatigue and a low-grade fever. There are no obvious symptoms of infection during the incubation period, and they are more specific during the full stage of illness, before disappearing by the convalescent period.

Despite a national focus on health promotion, nurses working with patients in inner-city clinics continue to see disparities in health care for vulnerable populations. Which patients would be considered vulnerable populations? Select all that apply. a. A White male diagnosed with HIV b. An African American teenager who is 6 months pregnant c. A Hispanic male who has type II diabetes d. A low-income family living in rural America e. A middle-class teacher living in a large city f. A White baby who was born with cerebral palsy

b, c, d, f. National trends in the prevention of health disparities are focused on vulnerable populations, such as racial and ethnic minorities, those living in poverty, women, children, older adults, rural and inner-city residents, and people with disabilities and special health care needs.

The nurse instructor is teaching student nurses about the factors that may affect a patient's blood pressure. Which statements accurately describe these factors? Select all that apply. a. Blood pressure decreases with age. b. Blood pressure is usually lowest on arising in the morning. c. Women usually have lower blood pressure than men until menopause. d. Blood pressure decreases after eating food. e. Blood pressure tends to be lower in the prone or supine position. f. Increased blood pressure is more prevalent in African Americans.

b, c, e, f. Blood pressure increases with age due to a decreased elasticity of the arteries, increasing peripheral resistance. Blood pressure is usually lowest on arising in the morning. Women usually have lower blood pressure than men until menopause occurs. Blood pressure increases after eating food. Blood pressure tends to be lower in the prone or supine position. Increased blood pressure is more prevalent and severe in African American men and women.

A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply. a. A system is a set of individual elements that rarely interact with each other. b. The whole system is always greater than its parts. c. Boundaries separate systems from each other and their environments. d. A change in one subsystem will not affect other subsystems. e. To survive, open systems maintain balance through feedback. f. A closed system allows input from and to the environment.

b, c, e. According to general systems theory, a system is a set of interacting elements contributing to the overall goal of the system. The whole system is always greater than its parts. Boundaries separate systems from each other and their environments. Systems are hierarchical in nature and are composed of interrelated subsystems that work together in such a way that a change in one element could affect other subsystems, as well as the whole. To survive, open systems maintain balance through feedback. An open system allows energy, matter, and information to move freely between sys- tems and boundaries, whereas a closed system does not allow input from or output to the environment.

Health promotion activities may occur on a primary, second- ary, or tertiary level. Which activities are considered tertiary health promotion? Select all that apply. a. A nurse runs an immunization clinic in the inner city. b. A nurse teaches a patient with an amputation how to care for the residual limb. c. A nurse provides range-of-motion exercises for a para- lyzed patient. d. A nurse teaches parents of toddlers how to childproof their homes. e. A school nurse provides screening for scoliosis for the students. f. A nurse teaches new parents how to choose and use an infant car seat.

b, c. Tertiary health promotion and disease prevention begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate patients to a maximum level of func- tioning. These activities include providing ROM exercises and patient teaching for residual limb care. Providing immu- nizations and teaching parents how to childproof their homes and use an appropriate car seat are primary health promotion activities. Providing screenings is a secondary health promo- tion activity.

A nurse who is caring for older adults in a senior daycare center documents findings as related to which normal aging process? Select all that apply. a. A patient's increased skin elasticity causes wrinkles on the face and arms. b. Exposure to sun over the years causes a patient's skin to be pigmented. c. A patient's toenails have become thinner with a bluish tint to the nail beds. d. A patient experiences a hip fracture due to porous and brittle bones. e. Fragile blood vessels in the dermis allow for more easy bruising of a patient's forearm. f. Increased bladder capacity causes decreased voiding in an older patient.

b, d, e. Exposure to sun over the years can cause a patient's skin to be pigmented. Bone demineralization occurs with aging, causing bones to become porous and brittle, making fractures more common. The blood vessels in the dermis become more fragile, causing an increase in bruising and purpura. Wrinkling and sagging of skin occur with decreased skin elasticity. A patient's toenails may become thicker, with a yellowish tint to the nail beds. Bladder capacity decreases by 50%, making voiding more frequent; two or three times a night is usual.

A nurse is planning teaching strategies for patients addicted to alcohol, in the affective domain of learning. What are examples of strategies promoting behaviors in this domain? Select all that apply. a. The nurse prepares a lecture on the harmful long-term effects of alcohol on the body. b. The nurse explores the reasons alcoholics drink and pro- motes other methods of coping with problems. c. The nurse asks patients for a return demonstration for using relaxation exercises to relieve stress. d. The nurse helps patients to reaffirm their feelings of self- worth and relate this to their addiction problem. e. The nurse uses a pamphlet to discuss the tenants of the Alcoholics Anonymous program to patients. f. The nurse reinforces the mental benefits of gaining self- control over an addiction.

b, d, f. Affective learning includes changes in attitudes, values, and feelings (e.g., the patient expresses renewed self-confidence to be able to give up drinking). Cognitive learning involves the storing and recalling of new knowledge in the brain, such as the learning that occurs during a lecture or by using a pamphlet for teaching. Learning a physical skill involving the integration of mental and muscular activity is called psychomotor learning, which may involve a return demonstration of a skill.

Following a fall that left an elderly male patient temporarily bedridden, the nurse is using the SPICES assessment tool to evaluate him for cascade iatrogenesis. Which are correct aspects of this tool? Select all that apply. a. S - Senility b. P - Problems with feeding c. I - Irritableness d. C - Confusion e. E - Edema of the legs f. S - Skin breakdown

b, d, f. The SPICES acronym is used to identify common problems in older adults and stands for: S - Sleep disorders P - Problems with eating or feeding I - Incontinence C - Confusion E - Evidence of falls S - Skin breakdown (Fulmer & Wallace, 2012).

Which nursing actions reflect the use of philosophy as a knowledge base when delivering evidence-based care to patients? Select all that apply. a. A nurse interviews and examines a new patient diagnosed with prehypertension to formulate a care plan. b. A nurse draws from personal experiences of being a patient to establish a therapeutic relationship with a patient. c. A nurse searches the Internet to find the latest treatments for type 2 diabetes. d. A nurse uses spiritual training to draw strength when counseling a patient who is in hospice for an inoperable brain tumor. e. A nurse follows the protocol for assessing postoperative patients in the ICU. f. A nursing student studies anatomy and physiology of the body systems to understand the disease states of assigned patients.

b, d. Philosophy is the study of wisdom, fundamental knowl- edge, and the processes used to develop and construct one's perceptions of life. A philosophy is developed from personal experiences (such as the experience of being the patient), through formal and informal educational experiences, through religion and culture (such as using spiritual training as a source of strength), and from the environment. Interviewing and examining patients to formulate a care plan and using protocol for assessing patients in the ICU involve knowledge of processes. Researching the Internet and studying anatomy and physiology use scientific knowledge to deliver evidence- based care.

The nurse is prioritizing nursing care for a patient in a long-term care facility. Which examples of nursing interventions help meet physiologic needs? Select all that apply. a. Preventing falls in the facility b. Changing a patient's oxygen tank c. Providing materials for a patient who likes to draw d. Helping a patient eat his dinner e. Facilitating a visit from a spouse f. Referring a patient to a cancer support group.

b, d. Physiologic needs—oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest—must be met at least minimally to maintain life. Providing food and oxygen are examples of interventions to meet these needs. Preventing falls helps meet safety and security needs, provid- ing art supplies may help meet self-actualization needs, facili- tating visits from loved ones helps meet self-esteem needs, and referring a patient to a support group helps meet love and belonging needs.

A nurse is performing hand hygiene after providing patient care. The nurse's hands are not visibly soiled. Which steps in this procedure are performed correctly? Select all that apply. a. The nurse removes all jewelry including a platinum wed- ding band. b. The nurse washes hands to one inch above the wrists. c. The nurse uses approximately two teaspoons of liquid soap. d. The nurse keeps hands higher than elbows when placing under faucet. e. The nurse uses friction motion when washing for at least 15 seconds. f. The nurse rinses thoroughly with water flowing toward fingertips.

b, e, f. Proper hand hygiene includes removing jewelry with the exception of a plain wedding band, wetting the hands and wrist area with the hands lower than the elbows, using about one teaspoon of liquid soap, using friction motion for at least 15 seconds, washing to one inch above the wrists with a friction motion for at least 15 seconds, and rinsing thoroughly with water flowing toward fingertips.

A nurse assesses patients in a physician's office who are experiencing different levels of health and illness. Which statements best define the concepts of health and illness? Select all that apply. a. Health and illness are the same for all people. b. Health and illness are individually defined by each person. c. People with acute illnesses are actually healthy. d. People with chronic illnesses have poor health beliefs. e. Health is more than the absence of illness. f. Illness is the response of a person to a disease.

b,e,f. Each person defines health and illness individually, based on a number of factors. Health is more than just the absence of illness; it is an active process in which a person moves toward one's maximum potential. An illness is the response of the person to a disease.

A nurse who is caring for a morbidly obese male teenager forms a contractual agreement with him to achieve his weight goals. Which statement best describes the nature of this agreement? a. "This agreement forms a legal bond between the two of us to achieve your weight goals." b. "This agreement will motivate the two of us to do what is necessary to meet your weight goals." c. "This agreement will help us determine what learning outcomes are necessary to achieve your weight goals." d. "This agreement will limit the scope of the teaching session and make stated weight goals more attainable."

b. A contractual agreement is a pact two people make setting out mutually agreed-on goals. Contracts are usually informal and not legally binding. When teaching a patient, such an agreement can help motivate both the patient and the teacher to do what is necessary to meet the patient's learning out- comes. The agreement notes the responsibilities of both the teacher and the learner, emphasizing the importance of the mutual commitment.

The nurse records an APGAR score of 4 for a newborn. What would be the priority intervention for this newborn? a. No interventions are necessary; this is a normal score. b. Provide respiratory assistance. c. Perform CPR. d. Wait 5 minutes and repeat the scoring process.

b. A newborn who scores a 4 on the APGAR chart requires special assistance such as respiratory assistance. Normal APGAR scores are 7 to 10. Neonates who score between 4 and 6 require special assistance, and those who score below 4 are in need of life-saving support.

A nurse working with adolescents in a group home discusses the developmental tasks appropriate for adolescents with the staff. What is an example of a primary developmental task of the adolescent? a. Working hard to succeed in school b. Spending time developing relationships with peers c. Developing athletic activities and skills d. Accepting the decisions of parents

b. Adolescence is a time to establish more mature relation- ships with both boys and girls of the same age.

A student nurse is learning to assess blood pressure. What does the blood pressure measure? a. Flow of blood through the circulation b. Force of blood against arterial walls c. Force of blood against venous walls d. Flow of blood through the heart

b. Blood pressure is the measurement of the force of blood against arterial walls.

The nurse caring for patients postoperatively uses careful hand hygiene and sterile techniques when handling patients. Which of Maslow's basic human needs is being met by this nurse? a. Physiologic b. Safety and security c. Self-esteem d. Love and belonging

b. By carrying out careful hand hygiene and using sterile technique, nurses provide safety from infection. An example of a physiologic need is clearing a patient's airway. Self- esteem needs may be met by allowing an older adult to talk about a past career. An example of helping meet a love and belonging need is contacting a hospitalized patient's family to arrange a visit.

Which method of qualitative research was developed by the discipline of anthropology? a. Historical b. Ethnography c. Grounded theory d. Phenomenology

b. Ethnographic research was developed by the discipline of anthropology and is used to examine issues of culture of interest to nursing. Historical research examines events of the past to increase understanding of the nursing profession today. The basis of grounded theory methodology is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene. The purpose of phenomenology (both a philosophy and a research method) is to describe experiences as they are lived by the subjects being studied.

A nurse teaches a patient at home to use clean technique when changing a wound dressing. This practice is considered: a. The nurse's preference b. Safe for the home setting c. Unethical behavior d. Grossly negligent

b. In the home setting, where the patient's environment is more controlled, medical asepsis is usually recommended, with the exception of self-injection. This is the appropriate procedure for the home and is neither unethical nor grossly negligent.

The nurse caring for families in a free health care clinic identifies psychosocial risk factors for altered family health. Which example describes one of these risk factors? a. The family does not have dental care insurance or resources to pay for it. b. Both parents work and leave a 12-year old child to care for his younger brother. c. Both parents and their children are considerably overweight. d. The youngest member of the family has cerebral palsy and needs assistance from community services.

b. Inadequate childcare resources is a psychosocial risk factor. Not having access to dental care and obese family members are lifestyle risk factors. Having a family member with birth defects is a biologic risk factor.

A nurse is providing care based on Maslow's hierarchy of basic human needs. For which nursing activities is this approach useful? a. Making accurate nursing diagnoses b. Establishing priorities of care c. Communicating concerns more concisely d. Integrating science into nursing care

b. Maslow's hierarchy of basic human needs is useful for establishing priorities of care.

Based on Erikson's theory, middle adults who do not achieve their developmental tasks may be considered to be in stagna- tion. Which statement is one example of this finding? a. "I am helping my parents move into an assisted-living facility." b. "I spend all of my time going to the doctor to be sure I am not sick." c. "I have enough money to help my son and his wife when they need it." d. "I earned this gray hair and I like it!"

b. Middle adults who do not reach generativity tend to become overly concerned about their own physical and emotional health needs.

The nurse encourages parents of hospitalized infants and toddlers to stay with their child to help decrease what potential problem? a. Problems with attachment b. Separation anxiety c. Risk for injury d. Failure to thrive

b. Separation anxiety, with crying initially and then appearing depressed, is common during late infancy in infants who are hospitalized.

A nurse is caring for a 42-year-old male patient who is admitted to the hospital with injuries sustained in a motor vehicle accident. While he is in the hospital, his wife tells him that the bottom level of their house flooded, damaging their belongings. When the nurse enters his room, she notes that the patient is visibly upset. The nurse is aware that the patient will most likely be in need of which type of counseling? a. Long-term developmental b. Short-term situational c. Short-term motivational d. Long-term motivational

b. Short-term counseling might be used during a situational crisis, which occurs when a patient faces an event or situation that causes a disruption in life, such as a flood. Long-term counseling extends over a prolonged period; a patient experiencing a developmental crisis, for example, might need long- term counseling. Motivational interviewing is an evidence- based counseling approach that involves discussing feelings and incentives with the patient. A caring nurse can motivate patients to become interested in promoting their own health.

A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching? a. Promoting health b. Preventing illness c. Restoring health d. Facilitating coping

b. Teaching first aid is a function of the goal to prevent ill- ness. Promoting health involves helping patients to value health and develop specific health practices that promote wellness. Restoring health occurs once a patient is ill, and teaching focuses on developing self-care practices that pro- mote recovery. When facilitating coping, nurses help patients come to terms with whatever lifestyle modification is needed for their recovery or to enable them to cope with permanent health alterations.

The National Advisory Council on Nurse Education and Practice identifies critical challenges to nursing practice in the 21st century. What is a current health care trend contributing to these challenges? a. Decreased numbers of hospitalized patients b. Older and more acutely ill patients c. Decreasing health care costs due to managed care d. Slowed advances in medical knowledge and technology

b. The National Advisory Council on Nurse Education and Practice identifies the following critical challenges to nursing practice in the 21st century: A growing population of hospitalized patients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology.

A patient has intravenous fluids infusing in the right arm. When taking a blood pressure on this patient, what would the nurse do in this situation? a. Take the blood pressure in the right arm b. Take the blood pressure in the left arm c. Use the smallest possible cuff d. Report inability to take the blood pressure

b. The blood pressure should be taken in the arm opposite the one with the infusion.

A nurse has taught a diabetic patient how to administer his daily insulin. The nurse should evaluate the teaching-learning process by: a. Determining the patient's motivation to learn b. Deciding if the learning outcomes have been achieved c. Allowing the patient to practice the skill he has just learned d. Documenting the teaching session in the patient's medical record

b. The nurse cannot assume that the patient has actually learned the content unless there is some type of proof of learning. The key to evaluation is meeting the learner out- comes stated in the teaching plan.

A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a loss of consciousness in the emergency room. The nurse anticipates preparing the patient for ordered diagnostic tests. This nurse's knowledge of the diagnostic procedures for this condition reflects which aspect of nursing? a. The art of nursing b. The science of nursing c. The caring aspect of nursing d. The holistic approach to nursing

b. The science of nursing is the knowledge base for care that is provided. In contrast, the skilled application of that knowledge is the art of nursing. Providing holistic care to patients based on the science of nursing is considered the art of nursing.

A nurse who is caring for a patient diagnosed with HIV/AIDS incurs a needlestick injury when administering the patient's medications. What would be the priority action of the nurse following the exposure? a. Report the incident to the appropriate person and file an incident report. b. Wash the exposed area with warm water and soap. c. Consent to postexposure prophylaxis at appropriate time. d. Set up counseling sessions regarding safe practice to protect self.

b. When a needlestick injury occurs, the nurse should wash the exposed area immediately with warm water and soap, report the incident to the appropriate person and complete an incident injury report, consent to and await the results of blood tests, consent to postexposure prophylaxis, and attend counseling sessions regarding safe practice to protect self and others.

A nurse's neighbor tells the nurse, "I have a high temperature, feel awful, and I am not going to work." What stage of illness behavior is the neighbor exhibiting? a. Experiencing symptoms b. Assuming the sick role c. Assuming a dependent role d. Achieving recovery and rehabilitation

b. When people assume the sick role, they define themselves as ill, seek validation of this experience from others, and give up normal activities. In stage 1: experiencing symptoms, the first indication of an illness usually is recognizing one or more symptoms that are incompatible with one's personal definition of health. The stage of assuming a depend- ent role is characterized by the patient's decision to accept the diagnosis and follow the prescribed treatment plan. In the achieving recovery and rehabilitation role, the person gives up the dependent role and resumes normal activities and responsibilities.

A nurse is using personal protective equipment (PPE) when bathing a patient diagnosed with C. difficile infection. Which nursing action related to this activity promotes safe, effective patient care? a. The nurse puts on PPE after entering the patient room. b. The nurse works from "clean" areas to "dirty" areas during bath. c. The nurse personalizes the care by substituting glasses for goggles. d. The nurse removes PPE prior to leaving the patient room.

b. When using PPE, the nurse should work from "clean" areas to "dirty" ones, put on PPE before entering the patient room, always use goggles instead of personal glasses, and remove PPE in the doorway or anteroom.

A nurse is following the principles of medical asepsis when performing patient care in a hospital setting. Which nursing action performed by the nurse follows these recommended guidelines? a. The nurse carries the patients' soiled bed linens close to the body to prevent spreading microorganisms into the air. b. The nurse places soiled bed linens and hospital gowns on the floor when making the bed. c. The nurse moves the patient table away from the nurse's body when wiping it off after a meal. d. The nurse cleans the most soiled items in the patient's bathroom first and follows with the cleaner items.

c. According to the principles of medical asepsis, the nurse should move equipment away from the body when brushing, scrubbing, or dusting articles to prevent contaminated particles from settling on the hair, face, or uniform. The nurse should carry soiled items away from the body to prevent them from touching the clothing. The nurse should not put soiled items on the floor, as it is highly contaminated. The nurse should also clean the least soiled areas first and then move to the more soiled ones to prevent having the cleaner areas soiled by the dirtier areas.

A nurse is teaching patients of all ages in a hospital setting. Which examples demonstrate teaching that is appropriately based on the patient's developmental level? Select all that apply. a. The nurse plans long teaching sessions to discuss diet modifications for an older adult diagnosed with type 2 diabetes. b. The nurse recognizes that a female adolescent diagnosed with anorexia is still dependent on her parents and includes them in all teaching sessions. c. The nurse designs an exercise program for a sedentary older adult male patient based on the activities he prefers. d. The nurse includes an 8-year-old patient in the teaching plan for managing cystic fibrosis. e. The nurse demonstrates how to use an inhaler to an 11-year-old male patient and includes his mother in the session to reinforce the teaching. f. The nurse continues a teaching session on STIs for a sexually active male adolescent despite his protest that "I've heard enough already!"

c, d, e. Successful teaching plans for older adults incorporate extra time, short teaching sessions, accommodation forsensory deficits, and reduction of environmental distractions. Older adults also benefit from instruction that relates new information to familiar activities or information. School- aged children are capable of logical reasoning and should be included in the teaching-learning process whenever possible; they are also open to new learning experiences but need learning to be reinforced by either a parent or health care provider as they become more involved with their friends and school activities. Teaching strategies designed for an adolescent patient should recognize the adolescent's need for independence, as well as the need to establish a trusting relationship that demonstrates respect for the adolescent's opinions.

Which phrase describes a purpose of the ANA's Nursing's Social Policy Statement? Select all that apply. a. To describe the nurse as a dependent caregiver b. To provide standards for nursing educational programs c. To define the scope of nursing practice d. To establish a knowledge base for nursing practice e. To describe nursing's social responsibility f. To regulate nursing research

c, d, e. The ANA Social Policy Statement (2010) describes the social context of nursing, a definition of nursing, the knowledge base for nursing practice, the scope of nursing practice, standards of professional nursing practice, and the regulation of professional nursing.

A school nurse is preparing a talk on safety issues for parents of school-aged children to present at a parent-teacher meeting. Which topics should the nurse include based on the age of the children? Select all that apply. a. Child-proofing the home b. Choosing a car seat c. Teaching pedestrian traffic safety d. Providing swimming lessons and water safety rules e. Discussing alcohol and drug consumption related to motor vehicle safety f. Teaching child how to "stop, drop, and roll"

c, d, f. Important safety topics for school-aged children include pedestrian traffic safety, water safety, and fire safety. Childproofing a home would be appropriate for parents of a toddler, choosing a car seat would be an appropriate topic for parents of an infant or toddler, and teaching drug and alcohol as it relates to motor vehicle safety would be a more appropriate topic for parents of adolescents.

A nurse caring for adults in a physician's office notes that some patients age more rapidly that other patients of the same age. The nurse researches aging theories that attempt to describe how and why aging occurs. Which statements apply to the immunity theory of aging? Select all that apply. a. Chemical reactions in the body produce damage to the DNA. b. Free radicals have adverse effects on adjacent molecules. c. Decrease in size and function of the thymus causes infections. d. There is much interest in the role of vitamin supplementation. e. Lifespan depends on a great extent to genetic factors. f. Organisms wear out from increased metabolic functioning.

c, d. The immunity theory of aging focuses on the functions of the immune system and states that the immune response declines steadily after younger adulthood as the thymus loses size and function, causing more infections. There is much interest in vitamin supplements (such as vitamin E) to improve immune function. In the cross-linkage theory, cross-linkage is a chemical reaction that produces damage to the DNA and cell death. The free radical theory states that free radicals, formed during cellular metabolism, are molecules with separated high-energy electrons, which can have adverse effects on adjacent molecules. The genetic theory of aging holds that lifespan depends to a great extent on genetic factors. According to the wear-and-tear theory, organisms wear out from increased metabolic functioning, and cells become exhausted from continual energy depletion from adapting to stressors (Eliopoulos, 2010).

Nursing is recognized increasingly as a profession based on which defining criteria? Select all that apply. a. Well defined body of general knowledge b. Interventions dependent upon the medical practice c. Recognized authority by a professional group d. Regulation by the medical industry e. Code of ethics f. Ongoing research

c, e, f. Nursing is recognized increasingly as a profession based on the following defining criteria: well-defined body of specific and unique knowledge, strong service orientation, recognized authority by a professional group, code of ethics, professional organization that sets standards, ongoing research, and autonomy and self-regulation.

The nurse caring for patients in a long-term care facility knows that the highest level on Maslow's hierarchy of needs is self-actualization needs. Which statements accurately describe the achievement of self-actualization? Select all that apply. a. Humans are born with a fully developed sense of self- actualization. b. Self-actualization needs are met by depending on others for help. c. The self-actualization process continues throughout life. d. Loneliness and isolation occur when self-actualization needs are unmet. e. A person achieves self-actualization by focusing on problems outside self. f. Self-actualization needs may be met by creatively solving problems.

c, e, f. Self-actualization, or reaching one's full potential, is a process that continues throughout life. A person achieves self-actualization by focusing on problems outside oneself and using creativity as a guideline for solving problems and pursuing interests. Humans are not born with a fully devel- oped sense of self-actualization, and self-actualization needs are not met specifically by depending on others for help. Loneliness and isolation are not always the result of unmet self-actualization needs.

A nursing instructor teaching classes in gerontology to nursing students discusses myths related to the aging of adults. Which statement is a myth about older adults? a. Most older adults live in their own homes. b. Healthy older adults enjoy sexual activity. c. Old age means mental deterioration. d. Older adults want to be attractive to others.

c. Although response time may be longer, intelligence does not normally decrease because of aging. Most older adults own their own homes, and although sexual activity may be less frequent, the ability to perform and enjoy sexual activity lasts well into the 90s in healthy older adults. Older adults want to be attractive to others.

When conducting quantitative research, the researcher col- lects information to support a hypothesis. This information would be identified as: a. The subject b. Variables c. Data d. The instrument

c. Data refers to information that the researcher collects from subjects in the study (expressed in numbers). A variable is something that varies and has different values that can be measured. Instruments are devices used to collect and record the data, such as rating scales, pencil-and-paper tests, and biologic measurements.

A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating? a. Tertiary b. Secondary c. Primary d. Promotive

c. Giving influenza injections is an example of primary health promotion and illness prevention.

A nurse is finished with patient care. How would the nurse remove PPE when leaving the room? a. Remove gown, goggles, mask, gloves, and exit the room. b. Remove gloves, perform hand hygiene, then remove gown, mask, and goggles. c. Untie gown waiststrings, remove gloves, goggles, gown, mask; perform hand hygiene. d. Remove goggles, mask, gloves, gown, and perform hand hygiene.

c. If an impervious gown has been tied in front of the body at the waist, the nurse should untie the waist strings before removing gloves. Gloves are always removed first because they are most likely to be contaminated, followed by the goggles, gown, and mask, and hands should be washed thoroughly after the equipment has been removed and before leaving the room.

A nurse is preparing a sterile field using a packaged sterile drape for a confused patient who is scheduled for a surgical procedure. When setting up the field, the patient accidentally touches an instrument in the sterile field. What is the appropriate nursing action in this situation? a. Ask another nurse to hold the hand of the patient and continue setting up the field. b. Remove the instrument that was touched by the patient and continue setting up the sterile field. c. Discard the supplies and prepare a new sterile field with another person holding the patient's hand. d. No action is necessary since the patient has touched his or her own sterile field.

c. If the patient touches a sterile field, the nurse should dis- card the supplies and prepare a new sterile field. If the patient is confused, the nurse should have someone assist by holding the patient's hand and reinforcing what is happening.

A nurse who is working with women in a drop-in shelter studies Carol Gilligan's theory of morality in women to use when planning care. According to Gilligan, what is the motivation for female morality? a. Law and justice b. Obligations and rights c. Response and care d. Order and selfishness

c. In Gilligan's theory, males and females have different ways of looking at the world. Males are more likely to associate morality with obligations, rights, and justice. Females are more likely to see moral requirements emerging from the needs of others within the context of a relationship.

The nurse assesses patients to determine their risk for health care-associated infections. Which hospitalized patient is most at risk for developing this type of infection? a. A 60-year-old patient who smokes two packs of cigarettes daily b. A 40-year-old patient who has a white blood cell count of 6,000/mm3 c. A 65-year-old patient who has an indwelling urinary catheter in place d. A 60-year-old patient who is a vegetarian and slightly underweight

c. Indwelling urinary catheters have been implicated in most health care-associated infections. Cigarette smoking, a normal white blood cell count, and a vegetarian diet have not been implicated as risk factors for HAIs.

A nurse is interviewing Anthony, a 42-year-old patient who visits his internist for a blood pressure screening. Anthony tells the nurse that he is currently a sales associate but is considering a different career. He states that he is "a little anxious about the process." According to Levinson, what phase of adult life is Anthony experiencing? a. Entering the adult world b. Settling down c. Midlife transition d. The pay-off years

c. Midlife transition (age 40-45) involves a reappraisal of one's goals and values. The established lifestyle may continue, or the individual may choose to reorganize and change careers. This is an unsettled time, with the individual often anxious and fearful. The years of the middle to late 20s (age 22-28) are a time to build on previous decisions and choices and to try different careers and lifestyles. In the settling-down phase (age 30-40), the adult invests energy into the areas of life that are most personally important. The years from 45 to 65 are a time of maximum self-direction and self-approval.

A nurse examining a toddler in a pediatric office document that the child is in the 90th percentile for height and weight and has blue eyes. These physical characteristics are primarily determined by: a. Socialization with caregivers b. Maternal nutrition during pregnancy c. Genetic information on chromosomes d. Meeting developmental tasks

c. Physical appearance and growth have a predetermined genetic base in inheritance patterns carried on the chromosomes.

A nurse is teaching parents of toddlers how to spend quality time with their children. Which activity would be develop- mentally appropriate for this age group? a. Playing video games b. Playing peek-a-boo c. Playing in a sand box d. Playing board games

c. Playing in a sand box with toys that emphasize gross motor skills and creativity is a developmentally appropriate activity for a toddler. Video games are appropriate for school-aged children and adolescents, but should be monitored. Playing peek-a-boo is developmentally appropriate for an infant, and playing board games usually begins with preschool and older children.

Which type of quantitative research is often conducted to examine the effects of nursing interventions on patient outcomes? a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research

c. Quasi-experimental research is often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes. Descriptive research is often used to generate new knowledge about topics with little or no prior research. Correlational research examines the type and degree of relationships between two or more variables. Experimental research examines cause-and-effect relationships between variables under highly controlled conditions.

Which clinic patient is most likely to have annual breast examinations and mammograms based on the physical human dimension? a. Jane, whose her best friend had a benign breast lump removed b. Sarah, who lives in a low-income neighborhood c. Tricia, who has a family history of breast cancer d. Nancy, whose family encourages regular physical examinations

c. The physical dimension includes genetic inheritance, age, developmental level, race, and gender. These components strongly influence the person's health status and health prac- tices. A family history of breast cancer is a major risk factor.

A nurse is teaching a 50-year-old male patient how to care for his new ostomy appliance. Which teaching aid would be most appropriate to confirm that the patient has learned the information? a. Ask Me 3 b. Newest Vital Sign c. Teach-back tool d. TEACH acronym

c. The teach-back tool is a method of assessing literacy and confirming that the learner understands health information received from a health professional. The Ask Me 3 is a brief tool intended to promote understanding and improve communication between patients and their providers. The Newest Vital Sign (NVS) is a reliable screening tool to assess low health literacy, developed to improve communications between patients and providers. The TEACH acronym is used to maximize the effectiveness of patient teaching by tuning into the patient, editing patient information, acting on every teaching moment, clarifying often, and honoring the patient as a partner in the process.

A visiting nurse performs a community assessment in an area of the city in which the nurse will be working. What is one element of a healthy community? a. Meets all the needs of its inhabitants b. Has mixed residential and industrial areas c. Offers access to health care services d. Has modern housing and condominiums

c.A healthy community offers access to health care services to treat illness and to promote health. A healthy community does not usually meet all the needs of its residents, but should be able to help with health issues such as nutrition, education, recreation, safety, and zoning regulations to separate residential sections from industrial ones. The age of housing is irrelevant as long as residences are maintained properly according to code.

A nurse is documenting a blood pressure of 120/80 mm Hg. The nurse interprets the 120 to represent: a. The rhythmic distention of the arterial walls as a result of increased pressure due to surges of blood with ventricular contraction b. The lowest pressure present on arterial walls while the ventricles relax c. The highest pressure present on arterial walls while the ventricles contract d. The difference between the pressure on arterial walls with ventricular contraction and relaxation

c.The systolic pressure is 120mmHg. The diastolic pressure is 80 mm Hg, the lowest pressure present on arterial walls when the heart rests between beats. The difference between the systolic and diastolic pressures is called the pulse pressure. The rhythmic distention of the arterial walls as a result of increased pressure due to surges of blood with ventricular contraction is the pulse.

Prioritization: Place the following descriptions of the phases of Korotkoff sounds in order from Phase I to Phase V. a. Characterized by muffled or swishing sounds that may temporarily disappear; also known as the auscultatory gap b. Characterized by distinct, loud sounds as the blood flows relatively freely through an increasingly open artery c. The last sound heard before a period of continuous silence, known as the second diastolic pressure d. Characterized by the first appearance of faint but clear tap- ping sounds that gradually increase in intensity; known as the systolic pressure e. Characterized by a distinct, abrupt, muffling sound with a soft, blowing quality; considered to be the first diastolic pressure

d, a, b, e, c. Phase I is characterized by the first appearance of faint but clear tapping sounds that gradually increase in intensity; the first tapping sound is the systolic pressure. Phase II is characterized by muffled or swishing sounds, which may temporarily disappear, especially in hypertensive people; the disappearance of the sound during the latter part of phase I and during phase II is called the auscultatory gap. Phase III is characterized by distinct, loud sounds as the blood flows relatively freely through an increasingly open artery. Phase IV is characterized by a distinct, abrupt, muffling sound with a soft, blowing quality; in adults, the onset of this phase is considered to be the first diastolic pressure. Phase V is the last sound heard before a period of continuous silence; the pressure at which the last sound is heard is the second diastolic pressure.

A nurse is practicing as a nurse-midwife in a busy OB-GYN office. Which degree in nursing is necessary to practice at this level? a. LPN b. ADN c. BSN d. MSN

d. A master's degree (MSN) prepares advanced practice nurses. Many master's graduates gain national certification in their specialty area, for example, as family nurse practitioners (FNPs) or nurse midwives.

While taking an adult patient's pulse, a nurse finds the rate to be 140 beats/min. What should the nurse do next? a. Check the pulse again in 2 hours. b. Check the blood pressure. c. Record the information. d. Report the rate to the primary care provider.

d. A rate of 140 beats/min in an adult is an abnormal pulse and should be reported to the primary care provider or the nurse in charge of the patient.

The school nurse uses the principles and theories of growth and development when planning programs for high school students. According to Havighurst, what is a developmental task for this age group? a. Finding a congenial social group b. Developing a conscience, morality, and a scale of values c. Achieving personal independence d. Achieving a masculine or feminine gender role

d. According to Havighurst, it is the role of the adolescent to achieve a masculine or feminine gender role. Developing a conscience, morality, and a scale of values and achieving personal independence are roles of middle childhood. Finding a congenial social group is a role of young adulthood.

Following assessment of an obese adolescent, a nurse considers nursing diagnoses for the patient. Which diagnosis would be most appropriate? a. Risk for injury b. Risk for delayed development c. Social isolation d. Disturbed body image

d. Adolescents who are obese are at high risk for a disturbed body image. Risk for injury would be appropriate for a risk taker, a risk factor for delayed development may be ADHD, and social isolation may occur with low self-esteem.

A nurse assesses an oral temperature for an adult patient. The patient's temperature is 37.5°C (99.5°F). What term would the nurse use to report this temperature? a. Febrile b. Hypothermia c. Hypertension d. Afebrile

d. Afebrile means without fever. This temperature is within the normal range for an adult. Fever (pyrexia) is an elevation of body temperature; a person with fever is said to be febrile. Hypothermia is a low body temperature and hyperthermia is a high body temperature.

An experienced nurse tells a younger nurse who is working in a retirement home that older adults are different and do not have the same desires, needs, and concerns as other age groups. The nurse also comments that most older adults have "outlived their usefulness." What is the term for this type of prejudice? a. Harassment b. Whistle blowing c. Racism d. Ageism

d. Ageism is a form of prejudice in which older adults are stereotyped by characteristics found in only a few members of their age group. Harassment occurs when a dominant per- son takes advantage of or overpowers a less dominant person (may involve sexual harassment or power struggles). Whistle blowing involves reporting illegal or unethical behavior in the workplace. Racism is prejudice against other races and ethnic groups.

Quantitative research

is a method of research conducted to gain insight by discovering meanings. At its core is the idea that reality is based on perceptions, which differ for each person and change over time.

The nurse has opened the sterile supplies and put on two ster- ile gloves to complete a sterile dressing change, a procedure that requires surgical asepsis. The nurse must: a. Keep splashes on the sterile field to a minimum. b. Cover the nose and mouth with gloved hands if a sneeze is imminent. c. Use forceps soaked in a disinfectant. d. Consider the outer 1 inch of the sterile field as contaminated.

d. Considering the outer inch of a sterile field as contaminated is a principle of surgical asepsis. Moisture such as from splashes contaminates the sterile field, and sneezing would contaminate the sterile gloves. Forceps soaked in disinfectant are not considered sterile.

Which nurse who was influential in the development of nursing in North America is regarded as the founder of American nursing? a. Clara Barton b. Lillian Wald c. Lavinia Dock d. Florence Nightingale

d. Florence Nightingale elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education. Clara Barton established the Red Cross in the United States in 1882. Lillian Wald is the founder of public health nursing. Lavinia Dock was a nursing leader and women's rights activist instrumental in womens' right to vote.

Which of the following nursing diagnoses would be appropriate for many middle adults? a. Risk for Imbalanced Nutrition: Less Than Body Requirements b. Delayed Growth and Development c. Self-Care Deficit d. Caregiver Role Strain

d. Many middle adults help care for aging parents and have concerns about their own health and ability to continue to care for an older family member. Caregivers often face 24-hour care responsibilities for extended periods of time, which creates physical and emotional problems for the caregiver.

The nurse caring for patients in a hospital setting institutes CDC standard precaution recommendations for which category of patients? a. Only patients with diagnosed infections b. Only patients with visible blood, body fluids, or sweat c. Only patients with nonintact skin d. All patients receiving care in hospitals

d. Standard precautions apply to all patients receiving care in hospitals, regardless of their diagnosis or possible infection status. These recommendations include blood; all body fluids, secretions, and excretions except sweat; nonintact skin; and mucous membranes.

What does the letter P represent? a. Comparison to another similar treatment b. Clearly defined, focused literature review c. Specific identification of the desired outcome d. Explicit descriptions of the population of interest

d. The P in the PICO format represents an explicit description of the patient population of interest. I represents the intervention, C represents the comparison, and O stands for the outcome.

A nurse is caring for an obese 62-year-old patient with arthritis who has developed an open reddened area over his sacrum. What is a priority nursing diagnosis for this patient? a. Imbalanced Nutrition: More Than Body Requirements related to immobility b. Impaired Physical Mobility related to pain and discomfort c. Chronic Pain related to immobility d. Risk for Infection related to altered skin integrity

d. The priority diagnosis in this situation is the possibility of an infection developing in the open skin area. The others may be potential or probable diagnoses for this patient and may also require nursing interventions after the first diagnosis is addressed.

In early civilizations, the theory of animism attempted to explain the mysterious changes occurring in bodily functions. Which statement describes a component of the development of nursing that occurred in this era? a. Women who committed crimes were recruited into nursing the sick in lieu of serving jail sentences. b. Nurses identified the personal needs of the patient and their role in meeting those needs. c. Women called deaconesses made the first visits to the sick and male religious orders cared for the sick and buried the dead. d. The nurse was the mother who cared for her family during sickness by using herbal remedies.

d. The theory of animism was based on the belief that every- thing in nature was alive with invisible forces and endowed with power. In this era, the nurse usually was the mother who cared for her family during sickness by providing physical care and herbal remedies. At the beginning of the 16th century the shortage of nurses led to the recruitment of women who had committed crimes to provide nursing care instead of going to jail. In the early Christian period, women called deaconesses made the first organized visits to sick people, and members of male religious orders gave nursing care and buried the dead. The influences of Florence Nightingale were apparent from the middle of the 19th century to the 20th century; one of her accomplishments was identifying the personal needs of the patient and the nurse's role in meeting those needs.

A nurse is counseling a 19-year-old male athlete who had his right leg amputated below the knee following a motorcycle accident. During the rehabilitation process, the patient refuses to eat or get up to ambulate on his own. He says to the nurse, "What's the point. My life is over now and I'll never be the football player I dreamed of becoming." What is the nurse counselor's best response to this patient? a. "You're young and have your whole life ahead of you. You should focus on your rehabilitation and make something of your life." b. "I understand how you must feel. I wanted to be a famous singer, but I wasn't born with the talent to be successful at it." c. "You should concentrate on other sports that you could play even with a prosthesis." d. "I understand this is difficult for you. Would you like to talk about it now or would you prefer me to make a referral to someone else?"

d. This answer communicates respect and sensitivity to the patient's needs and offers an opportunity to discuss his feelings with the nurse or another health care professional. The other answers do not allow the patient to express his feelings and receive the counseling he needs.

A nurse who created a sterile field for a patient is adding a sterile solution to the field. What is an appropriate action when performing this task? a. Place the bottle cap on the table with the edges down. b. Hold the bottle inside the edge of the sterile field. c. Hold the bottle with the label side opposite the palm of the hand. d. Pour the solution from a height of 4 to 6 inches (10 to 15 cm).

d. To add a sterile solution to a sterile field, the nurse would open the solution container according to directions and place the cap on the table away from the field with the edges up. The nurse would then hold the bottle outside the edge of the sterile field with the label side facing the palm of the hand and prepare to pour from a height of 4 to 6 inches (10 to 15 cm).

process

is a series of actions, changes, or functions intended to bring about a desired result. During a process, one takes systematic and continuous steps to meet a goal and uses both assessments and feedback to direct actions to meet the goal.

When you ask an experienced nurse why it is necessary to change the patient's bed every day, the nurse says, "I guess we have just always done it that way." This answer is an example of what type of knowledge? a. Instinctive knowledge b. Scientific knowledge c. Authoritative knowledge d. Traditional knowledge

d. Traditional knowledge is the part of nursing practice passed down from generation to generation, often with- out research data to support it. Scientific knowledge is that knowledge obtained through the scientific method (implying thorough research). Authoritative knowledge comes from an expert and is accepted as truth based on the person's perceived expertise. Instinct is not a source of knowledge.

A nurse works with families in crisis at a community mental health care facility. What is the best broad definition of a family? a. A father, a mother, and children b. A group whose members are biologically related c. A unit that includes aunts, uncles, and cousins d. A group of people who live together and depend on each other for support

d.Although all the responses may be true, the best definition is a group of people who live together and depend on each other for physical, emotional, or financial support.

Shuba and Raul are a couple in their late seventies. According to Duvall, which developmental task is appropriate for this older adult family? a. Maintain a supportive home base b. Strengthen marital relationships c. Cope with loss of energy and privacy d. Adjust to retirement

d.The developmental tasks of the family with older adults are to adjust to retirement and possibly to adjust to the loss of a spouse and loss of independent living. Maintaining a supportive home base and strengthening marital relationships are tasks of the family with adolescents and young adults. Coping with loss of energy and privacy is a task of the family with children.

Anal Stage (Ages 8 Months to 4 Years)

development of neuromuscular control to allow control of the anal sphincter. Toilet training is a crucial issue, requiring delayed gratification as the child compromises between enjoyment of bowel function and limits set by social expectations.

Health

is a state of optimal functioning or well-being.

Evidence-based practice (EBP)

in nursing is a problem-solving approach to making clinical decisions, using the best evidence available (considered "best" because it is collected from sources such as published research, national standards and guidelines, and reviews of targeted literature). EBP blends both the science and the art of nursing so that the best patient outcomes are achieved.

nursing process

is another of the major guidelines for nursing practice. The essential activities involved in the nursing process are assessing, diagnosing, planning, implementing, and evaluating

Concepts

like ideas, are abstract impressions organized into symbols of reality. Concepts describe objects, properties, and events and relationships among them.

inductive reasoning

one builds from specific ideas or actions to conclusions about general ideas.

deductive reasoning

one examines a general idea and then considers specific actions or ideas

Developmental theory

outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death.

Basic research

sometimes called pure or laboratory research, is designed to generate and refine theory, and the findings are often not directly useful in practice.

Systematic reviews

summarize findings from multiple studies of a specific clinical practice question or topic, and recommend practice changes and future directions for research.

Oral Stage (Ages 0 to 18 Months)

the infant uses the mouth as the major source of gratification and exploration. Pleasure is experienced from eating, biting, chewing, and sucking. The infant's primary need is for security. A major conflict occurs with weaning.